Telomere length predicts neutrophil recovery in the absence of G-CSF after autologous peripheral blood stem cell transplantation

Haemopoietic regeneration after autologous peripheral blood progenitor cell (PBPC) transplantation can be delayed in some patients despite adequate infusion of CD34+ cells. This suggests variability in the proliferation potential of the implanted cells, a capacity that may be predicted by their telomere length. To test this theory, telomere length was measured on stored apheresis samples from 36 patients aged 46.6±11.1 years, who had undergone successful autologous PBPC transplantation with a median of 5.6 × 106/kg (1.3 × 106–36.1 × 106/kg) CD34+ cells. The mean PBPC telomere length for the cohort was 9.4±2.3 kbp. For patients who did not receive G-CSF post transplantation (n=7), days to absolute neutrophil recovery (ANC), ⩾0.1, 0.5 and 1.0 × 109 cells/l, were significantly inversely correlated with telomere length of the infused PBPC (r=−0.88, −0.81, −0.77, respectively; P<0.05,). However, no correlation was found for patients who received G-CSF from day 1 post transplantation (n=20). These data suggest that for transplantation with sufficient CD34+ cells, neutrophil recovery is less efficient in patients receiving infusions of cells with short telomeres, but this deficiency can be corrected with adequate post transplantation administration of G-CSF.